Introduction: The purpose of this article is to present the results of microsurgical clipping or endovascular coil obliteration of unruptured intracranial aneurysms (UIA), in a single cerebrovascular center with regard to successful obliteration and periprocedural complications.
Methods: Data concerning patients with UIA were recorded in the neurovascular database of the neurosurgical department at the University of Frankfurt. The outcome of treatment was assessed with the modified Rankin Scale.
Results: 126 patients were treated by open surgery and 74 patients by endovascular coil obliteration. After treatment, the rate of new, mostly transient neurological deficits was 5%, and there were no deaths related to any treatment in this series. The outcome was good in 124 (98.4%) of the surgically treated patients and 73 (98.6%) of the endovascularly treated patients, and only 3 patients (1.5%) had a treatment-related unfavorable outcome. 98% of the treated aneurysms were satisfactorily obliterated. Seven endovascularly treated patients required retreatment because of coil compaction leading to recanalization of the aneurysm.
Conclusions: The majority of patients with unruptured intracranial aneurysms, even complex ones, can be treated by microsurgery or endovascular aneurysm obliteration with very good clinical results and a very low percentage of unfavorable outcomes. With careful patient selection and individualized assignment of the best form of treatment to each patient, we were able to achieve a low overall complication rate and a very high rate of obliteration in our specialized neurovascular center.
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http://dx.doi.org/10.3238/arztebl.2008.0449 | DOI Listing |
Neurosurg Rev
January 2025
Lab in Biotechnology and Biosignal Transduction, Department of Orthodontics, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai-77, Tamil Nadu, India.
Int J Surg
January 2025
Department of neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Background: Risk factors and mechanisms of cognitive impairment (CI) after aneurysmal subarachnoid hemorrhage (aSAH) are unclear. This study used a neuropsychological battery, MRI, ERP and CSF and plasma biomarkers to predict long-term cognitive impairment after aSAH.
Materials And Methods: 214 patients hospitalized with aSAH (n = 125) or unruptured intracranial aneurysms (UIA) (n = 89) were included in this prospective cohort study.
Acute Med Surg
January 2025
Department of Emergency and Critical Care Medicine Institute of Medicine, University of Tsukuba Hospital Tsukuba Ibaraki Japan.
Background: Traumatic intracranial aneurysms (TICAs) can be fatal if ruptured. We report a case of a TICA, distant from facial bone fractures, successfully treated with flow diverter (FD) before rupture.
Case Presentation: A 20-year-old woman was admitted following a car accident.
World Neurosurg
January 2025
Department of Neurological Surgery, University of Louisville, Louisville, KY, USA. Electronic address:
Aneurysms of the middle cerebral artery (MCA) account for up to 40% of all unruptured intracranial aneurysms [1-3] and 14% to 20% of ruptured ones. [4-5] Giant MCA aneurysms are rare, representing 10% of cases [6], but carry an aggressive natural history, with the UCAS Japan study reporting an annual rupture rate of ∼ 17%. [7].
View Article and Find Full Text PDFBrain Sci
January 2025
Department of Diagnostic and Interventional Neuroradiology, School of Medicine and Health, Technical University of Munich, 81675 Munich, Germany.
The p48 MW HPC is a novel low-profile flow diverter covered by a hydrophilic polymer coating with antithrombogenic properties, which may reduce ischemic complications and enable a single antiplatelet therapy after insertion of the stent. In this single-center experience, we describe the efficacy of this device, focusing on the illustration of different therapeutic indications and the outcome in various clinical settings with regard to vessel anatomy, bleeding state, and aneurysm configuration. We retrospectively reviewed our database for all patients being treated with a p48 MW HPC flow diverter between February 2019 and July 2021.
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